TB Epidemic Raging
Across Asia - Cases Soaring
From China To Afghanistan
UNICEF Calls for Global Action Against TB Epidemic

BANGKOK, Thailand (Reuters) - A tuberculosis epidemic is raging across Asia and, together with HIV/AIDS, poses a serious threat to the region's social and economic development, the United Nations Children's Fund said Friday.
UNICEF said in a statement eight million new cases of TB appeared every year and two million people died of the disease, which attacks the lungs.
Asia accounts for 70 percent of all TB cases and 10 Asian countries -- Bangladesh, Cambodia, China, India, Indonesia, Myanmar, Pakistan, the Philippines, Thailand and Vietnam -- are among 22 countries with the highest number of cases.
The director of UNICEF's East Asia and Pacific Regional Office, Kul Gautam, said TB was the single biggest global killer of young women, taking the lives of 750,000 women a year.
``The deep stigma of TB often results in women being ostracized by their families and communities, which in turn has a devastating impact on the well being of their children, families and society in general,'' he said in the statement.
``The result is that many thousands of aspiring families are driven back into poverty, while those families that were already impoverished must struggle even harder just to survive.''
Children were especially vulnerable to the effects of TB, which was often difficult to diagnose in young children and therefore difficult to treat effectively.
Children suffered serious social consequences when someone in their family had TB. In India, for example, over 300,000 children were withdrawn from school each year either to go to work to help their families bear the costs of TB care or due to the stigmatizing effects of the disease. ``Tb Can Be Prevented And Cured''
``But TB can be prevented and cured,'' Gautam said. ''Several countries in Asia, including such low-income countries as Cambodia and Vietnam, have developed model responses and are well on their way to effectively controlling the disease.
``The medical solutions are well within our reach and include a six-month directly observed treatment short-course of drugs.
``The remaining challenge is to mobilize sufficient political will to attack TB and to build a social partnership that includes governments, the business and private sector, concerned institutions, NGOs, and communities and families.''
UNICEF backed a call made in Amsterdam Friday, World TB Day, by ministers of health, finance and social welfare from around the world for global action to combat the disease.
UNICEF, working with other global health agencies, supports a ``Stop TB'' initiative in the Asia-Pacific. The initiative aims to reduce TB in the region by 50 percent in 10 years.
Although some two billion people were infected with TB, only a relatively small percentage ever develop the disease, it said.
But TB was opportunistic, and people whose immune systems had been weakened by HIV/AIDS faced a 30 times greater risk of developing the disease. Approximately 40 percent of people with HIV/AIDS also developed TB, and in many countries TB was also the leading cause of death for HIV/AIDS-infected people.
Gautam said urgent action was imperative to prevent the spread of TB and contain treatment costs because the number of multi-drug resistant forms of TB was on the rise.
Treating a normal case of TB with a six-month course of drugs costs as little as $11, but treating a multi-drug resistant case increased costs at least 100-fold. _____
China TB Rate One Of World's Worst 3-25-00
China has the world's second worst tuberculosis (TB) rate, Vice Health Minister Yin Dakui said, killing 250,000 people each year and threatening economic growth as most are of working age.
China has six million patients, about two million of whom are contagious, Yin said, adding the problem was second only to India.
Without effective measures, a further 200-300 million Chinese might be infected by TB in the next decade and a tenth of them might become contagious, Yin was quoted as saying in the official China Daily Friday.
TB is worse in China's impoverished rural areas than in cities where patients have access to better health care, the paper reported.
The risk is further heightened by the spread of HIV-AIDS and the rise in the number of internal migrants in China, it said.
"Hardly any other disease can cause direct damage to families and hinder social and economic developments more than TB," Yin said.
"It has incurred a great loss to the country as 75 percent of the TB patients are at the working age."
China set up two major projects to combat the spread of the disease over the past decade, one of which was funded by the World Bank, the paper said.
The 58 million dollar World Bank assisted project was started in 1992 and involved 13 provinces and cities across china.
By the end of 1999, 1.5 million contagious TB patients had been treated, 90 percent of whom were cured. ((c) 2000 Agence France Presse) _____
Tuberculosis spreading in Afghanistan killing thousands: experts 3-25-00
KABUL (AFP) - The protracted Afghan conflict has helped spread tuberculosis in this impoverished country, killing between 22,000 and 33,000 people every year, health officials said Saturday, marking World Tuberculosis Day.
Mohammad Shah Neikzad, head of the Afghanistan National Tuberculosis Institute said "tuberculosis deaths come to 22,000 to 33,000 (annually)," adding "there are 20,000 to 30,000 new cases recorded every year in addition to 44,000 to 66,000 positive cases that we have at the moment."
"The disease is spreading all over the country due to the economic problems of the people," he added.
He said 75 percent of victims were young people and 70 percent were female.
Neikzad said the disease was hard to bring under control as his institute lacked funds.
The 21-year-long war, which broke out with the 1979-1989 Soviet invasion of Afghanistan, had interrupted all tuberculosis control programmes in the country, he said.
The ruling Taliban religious militia, which holds most of the country, is currently battling a northern-based opposition alliance headed by former defence minister Ahmad Shah Masood.
He urged the Taliban administration to make a "political commitment" and the public to cooperate in curtailing the disease .
"The fighting has interrupted our programmes. We are endeavouring to rehabilitate it," he told a gathering of health officials here.
Mohammad Dayem Kakar, an official from the World Health Organization (WHO), said there were many tuberculosis patients just waiting to die due to a lack of health care in the areas close to the frontlines.
He also said the fighting made it difficult to present a precise figure for tuberculosis cases in the country.
There were reports the disease was spreading in central parts of the country, he said, suggesting other areas were similarly affected.
"Steps have been taken in the past three years. But we have not yet reached our targets as regards the disease control," Kakar said. "There might be more cases as we lack a precises census due to fighting."
According to the WHO official, people in Ghorband and Darae Souf to the northwest of Kabul, both battle grounds between the Taliban and Masood, lacked any tuberculosis health care.
"Ghorbad is a classic example of the disease in the country," he said.
But health care was not any better even in the capital's only hospital.
Around 20 female patients were languishing in dirty beds in this two-storey building in the absence of running water, electricity and proper care.
A dead, swollen dog was lying only three meters (yards) away from the hospital's gate which had only one, absent, nurse, three workers and one official.
"Our nurse has gone home. These workers take care of the patients," one official said, adding the patients were fed only plain rice for lunch and dinner.
He said MED AIR, an international aid group, was supplying medicine to the hospital.
Kathy Fiekert, MED AIR medical coordinator said they had supported the national institute for the past three years.
"We support them with medicines and incentives for the staff," she said.


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